Lack of cars, food made post-revolution Cubans healthy

Cubans were less prone to heart disease and diabetes during the 1990s when their country went through a prolonged economic crisis, a new study by the University of Michigan shows.

As in other nations, many people in Cuba have excess weight and live a sedentary lifestyle, both risk factors for heart disease and diabetes. In 1989, Cuba entered a prolonged economic crisis that worsened continuously over the next five years with dramatically reduced imports and shortages in the food-rationing system and public transportation. These conditions led to Cubans walking or riding a bike more often, eating less and smoking fewer cigarettes, the study shows.

"The findings were surprising because, during the economic crisis, Cubans' health conditions dramatically improved and the mortality rates declined," said José A. Tapia Granados, the study's co-author and an adjunct assistant professor in the U-M School of Social Work.

Researchers examined Cuban vital statistics and data from population surveys from 1980 to 2005 to determine the evolution of mortality during the severe economic crisis in 1991 to 1995 and the years before and immediately following.

The crisis reduced the daily per capita energy intake to 1,863 calories from nearly 2,900 calories. The lack of public transportation in Cuba meant residents had to find other means of travel. The prevalence of physical exercise, which is defined as at least 30 minutes of moderate or intense activity at least five days per week, jumped 30 percent to 67 percent, the research shows.

Food scarcity and increased energy expenditure from exercise made Cubans thinner, Tapia Granados said. The combined effect of reduced dietary energy intake and higher levels of physical activity helped many people who were obese or overweight to lose weight.

The Cuban population reached more healthy levels of body mass index, he said, and the prevalence of obesity declined from 14 percent to 7 percent. The annual per capita use of cigarettes also dropped, continuing a trend from 2,200 in 1980 to 1,200 in 1997.

When tracking the results from 1997 to 2002, there were declines in deaths attributed to diabetes (51 percent), coronary heart disease (35 percent), stroke (20 percent) and all causes (18 percent).

An outbreak of neuropathy—an acute eye disease, possibly caused by lack of micronutrients—and a slight increase in infant and elderly mortality show that the crisis also had negative consequences for health, Tapia Granados said.

The findings appear in the recent issue of the American Journal of Epidemiology. Manuel Franco and several researchers at John Hopkins University, Loyola University and the Hospital Universitario of Cienfuegos in Cuba also wrote the study.

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October 9, 2007